The information below comes from the statement of deficiencies compiled by health inspectors and provided to AHCJ by the Centers for Medicare and Medicaid Services. It does not include the steps the hospital plans to take to fix the problem, known as a plan of correction. For that information, you should contact the hospital, your state health department or CMS. Accessing the document may require you to file a Freedom of Information Request. Information on doing so is available here.

OSCEOLA REGIONAL MEDICAL CENTER 700 WEST OAK STREET KISSIMMEE, FL 34741 May 4, 2017
VIOLATION: IMPLEMENTATION OF A DISCHARGE PLAN Tag No: A0820
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**


Based on interview and record review, the facility failed to collaborate and coordinate a discharge plan for 1 of 10 sampled patients (#1).

Findings:

Patient #1 was admitted to the facility on [DATE]. He had a history of mental illness, homelessness, [DIAGNOSES REDACTED], indwelling urinary catheter and a powered wheelchair for ambulation. He was seen by psychiatric services on 1/03/17 for depression and medication recommendation. The recommendation was to collaborate with case manager for counseling therapy treatment in the community upon discharge.

The case management notes, dated 1/01/17, reflected that the manager was awaiting call back from a skilled nursing facility for patient placement. A case management progress note, dated 01/08/17, reflected that the patient was waiting for shelter placement. On 1/12/17, the note reflected that patient was discharged to a home in Ocala, Lake County.

A discharge summary by the physician, dated 1/10/17 at 4:05 PM, read, "the patient was supposed to go into the hotel and now, the case manager found that the patient can be accepted in a facility which is more appropriate in Ocala area....So he will be sent to SNF [skilled nursing facility] and will be followed by his PCP [primary care physician] in 1 week."

An interview with the patient's case manager on 5/04/17 at 12 PM revealed that the patient was difficult to place. She stated that he was discharged to a boarding home near Ocala, Florida. She stated that he did not require placement in a SNF because he was independent with his activities of daily living, was able to self-catheterize, and had completed his intravenous antibiotics. The case manager stated that the patient was made aware of the placement to the boarding home. She could not say how the patient would follow-up with his PCP, and about the psychiatry recommendation for counseling treatments in the community, since he was transferred to Ocala.

A review of the "Discharge Planning" policy, approved 3/08/16, read, "The patient ...is counseled by the interdisciplinary team to assure that the patient is: a. prepared for post hospital care, b. kept informed of the status or progress of the discharge plan, c. able to verbalize and or demonstrate the care needed and d. accepts the discharge plan."